RISIKO FRAKTUR PADA PASIEN HUMAN IMMUNODEFICIENCY VIRUS
Abstract
People living with HIV (PLWH) are frequently susceptible to experiencing complications, such as osteoporosis fractures, which occur as a result of decreased bone density caused by the virus, adverse effects of antiretroviral therapy (ART), clinical factors associated with reduced physiological functions due to aging, and unhealthy habits like smoking and alcohol consumption. With advancing age, the likelihood of experiencing osteoporotic fractures increases. Early diagnosis and fracture risk screening are crucial to preventing and reducing the probability of future fractures. The purpose of this study is to predict and describe the risk of fractures in PLWH over the next ten years, so that the results can be used as a source of information and a reference for intervention measures by nurses or other medical workers in attempts to decrease and prevent osteoporosis fractures. The research used quantitative-descriptive methods, with 76 respondents selected using consecutive sampling techniques. This study was conducted in November–December 2023 at the Lotus Poly Clinic, Sumedang Hospital. Without BMD, the fracture risk was calculated using the FRAX® tool. The findings of this study revealed that the overall PLWH has a low risk of major osteoporosis fractures, with a median of 2.20% (IQR 2), and a low risk of hip fractures, with a median of 0.2% (IQR 0.4). Although classified as low-risk, this highlights the importance of developing long-term pharmacological and non-pharmacological interventions, as well as regular bone health monitoring and preventive efforts through healthy lifestyles and appropriate medical management, to improve the quality of life of PLWH.
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References
2. UNAIDS 2023. Indonesia Snapshop Data. Race. 2013;(Unaids):1-3. https://www.aidsdatahub.org/resource/indonesia-country-snapshot-2023
3. Kementerian Kesehatan RI. Laporan Eksekutif Perkembangan HIV AIDS Dan Penyakit Infeksi Menular Seksual (PIMS) Triwulan III Tahun 2022. Siha.kemkes.go.id. Published online 2022:1-15. https://siha.kemkes.go.id/portal/files_upload/Laporan_TW_3_2022.pdf
4. Gunawan A. Sumedang Targetkan Zero New HIV Tahun 2030. Pemerintah Kabupaten Sumedang. Published 2023. https://sumedangkab.go.id/berita/detail/sumedang-targetkan-zero-new-hiv-tahun-2030
5. Cascio A, Colomba C, Carlo P Di, et al. Low bone mineral density in HIV-positive young Italians and migrants. PLoS One. 2020;15(9 September):1-14. doi:10.1371/journal.pone.0237984
6. Joann L. Porter; Matthew Varacallo. Osteoporosis. StatPearls [Internet]; 2023. https://www.ncbi.nlm.nih.gov/books/NBK441901/
7. Pramukti I, Lindayani L, Chen YC, et al. Bone fracture among people living with HIV: A systematic review and meta-regression of prevalence, incidence, and risk factors. PLoS One. 2020;15(6):1-14. doi:10.1371/journal.pone.0233501
8. Premaor MO, Compston JE. People living with HIV and fracture risk. Osteoporos Int. 2020;31(9):1633-1644. doi:10.1007/s00198-020-05350-y
9. Cervero M, Torres R, Agud JL, et al. Prevalence of and risk factors for low bone mineral density in Spanish treated HIV-infected patients. PLoS One. 2018;13(4):1-18. doi:10.1371/journal.pone.0196201
10. Correia IM, Navarro AM, Corrêa Cordeiro JF, et al. Bone Mineral Content Estimation in People Living with HIV: Prediction and Validation of Sex-Specific Anthropometric Models. Int J Environ Res Public Health. 2022;19(19). doi:10.3390/ijerph191912336
11. Biver E. Osteoporosis and HIV Infection. Calcif Tissue Int. 2022;110(5):624-640. doi:10.1007/s00223-022-00946-4
12. Delpino MV, Quarleri J. Influence of HIV Infection and Antiretroviral Therapy on Bone Homeostasis. Front Endocrinol (Lausanne). 2020;11(September):1-9. doi:10.3389/fendo.2020.00502
13. Mazzitelli M, Branca Isabel P, Muramatsu T, et al. FRAX assessment in people ageing with HIV. HIV Med. 2022;23(1):103-108. doi:10.1111/hiv.13170
14. Chang CJ, Chan YL, Pramukti I, Ko NY, Tai TW. People with HIV infection had lower bone mineral density and increased fracture risk: a meta-analysis. Arch Osteoporos. 2021;16(1). doi:10.1007/s11657-021-00903-y
15. Cabrera DM, Cornejo MP, Slotkin R, et al. Prevalence of and risk factors for vertebral fracture and low bone mineral density among Peruvian women aging with HIV. Arch Osteoporos. 2023;18(1). doi:10.1007/s11657-023-01250-w
16. Vandenput L, Johansson H, McCloskey E V., et al. Update of the Fracture Risk Prediction Tool FRAX: A Systematic Review of Potential Cohorts and Analysis Plan. Vol 33. Springer London; 2022. doi:10.1007/s00198-022-06435-6
17. Vizcarra P, Gallego J, Vivancos MJ, Sifuentes WA, Llop M, Casado JL. Evaluation of the fracture risk assessment tool for determining bone disease and the impact of secondary causes of osteoporosis in people living with HIV. HIV Res Clin Pract. 2020;0(0):63-71. doi:10.1080/25787489.2020.1794438
18. Brown TT, Hoy J, Borderi M, et al. Recommendations for evaluation and management of bone disease in HIV. Clin Infect Dis. 2015;60(8):1242-1251. doi:10.1093/cid/civ010
19. Pramukti I, Liu HY, Chen CC, et al. HCV co-infection among people living with HIV Is associated with Higher fracture risk. J Infect Public Health. 2020;13(11):1724-1728. doi:10.1016/j.jiph.2020.06.020
20. Stephens K, Rubinsztain L, Payan J, Rentsch C, Rimland D, Tangpricha V. Dual-Energy X-Ray Absorptiometry And Calculated Frax Risk Scores May Underestimate Osteoporotic Fracture Risk In Vitamin D-Deficient Veterans With Hiv Infection. Endocr Pract . 2016;22(4):440-446. doi:10.4158/EP15958.OR
21. Barron RL, Oster G, Grauer A, Crittenden DB, Weycker D. Determinants of imminent fracture risk in postmenopausal women with osteoporosis. Osteoporos Int. 2020;31(11):2103-2111. doi:10.1007/s00198-020-05294-3
22. Kepel FR, Lengkong AC. Fraktur geriatrik. e-CliniC. 2020;8(2):203-210. doi:10.35790/ecl.v8i2.30179
23. Ahmed M, Mital D, Abubaker NE, et al. Bone Health in People Living with HIV/AIDS: An Update of Where We Are and Potential Future Strategies. Microorganisms. 2023;11(3):1-17. doi:10.3390/microorganisms11030789
24. Costagliola D, Potard V, Lang S, et al. Impact of antiretroviral drugs on fracture risk in HIV-Infected individuals: A case-control study nested within the french hospital database on HIV (FHDH-ANRS CO4). J Acquir Immune Defic Syndr. 2019;80(2):214-223. doi:10.1097/QAI.0000000000001903
25. Meng W, Chen M, Song Y, Zhang H, Xie R, Zhang F. Prevalence and Risk Factors of Low Bone Mineral Density in HIV/AIDS Patients: A Chinese Cross-Sectional Study. J Acquir Immune Defic Syndr. 2022;90(3):360-368. doi:10.1097/QAI.0000000000002958
26. Kanis JA, Harvey NC, McCloskey E, et al. Algorithm for the management of patients at low, high and very high risk of osteoporotic fractures. Osteoporos Int. 2020;31(1):1-12. doi:10.1007/s00198-019-05176-3
27. Centre for Metabolic Bone Diseases, University of Sheffield U. Pertanyaan Umum. FRAX Perangkat Perhitungan Resiko Patah Tulang. https://frax.shef.ac.uk/FRAX/faq.aspx?lang=in
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